{"id":38703,"date":"2018-06-21T06:00:51","date_gmt":"2018-06-21T13:00:51","guid":{"rendered":"https:\/\/www.goodtherapy.org\/blog\/?p=38703"},"modified":"2024-02-21T14:49:05","modified_gmt":"2024-02-21T19:49:05","slug":"how-to-refer-someone-to-therapy-and-how-not-to","status":"publish","type":"post","link":"https:\/\/www.goodtherapy.org\/blog\/how-to-refer-someone-to-therapy-and-how-not-to-0621184","title":{"rendered":"How to Refer Someone to Therapy (and How Not To)"},"content":{"rendered":"

\"DoctorThe decision to initiate any interpersonal relationship is anxiety<\/a>-provoking, and the decision to talk with a therapist might be uniquely so. When we decide to meet with a therapist<\/a>, we are faced with numerous challenges: allowing ourselves to depend on someone else for help and support; revealing our problems; risking trust in a stranger; facing what we have avoided; and relinquishing long-held, sometimes beloved habits, to name a few.<\/p>\n

When we refer someone to therapy, it is important to keep this in mind. Though the statement \u00e2\u20ac\u0153I recommend you talk to a therapist\u00e2\u20ac\u009d sounds simple and benevolent enough, we cannot lose sight of the fact our caring act is simultaneously an anxiety-provoking challenge to the would-be person in therapy. So how can we go about this in a way that doesn\u00e2\u20ac\u2122t provoke any additional, unnecessary worries<\/a> or fears<\/a>?<\/p>\n

The following is a list of principles one can consider when making a referral to a therapist. While these ideas do not guarantee a certain outcome, they may reduce the chances of triggering anxiety that could promote avoidance.<\/p>\n

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1. Make it about their needs and goals.<\/strong><\/h3>\n

Therapy<\/a> is much more likely to succeed if the person is there of their own free will, motivated by their own goals, trying to meet their own needs. External pressures to be there and pressures to work on problems that other people see, but that we do not see, can lead therapies to get stuck. The last thing we want to do is refer someone to therapy because we<\/em> want them to change or conform to some goal that we <\/em>have for them. That\u00e2\u20ac\u2122s usually a recipe for someone either avoiding therapy or showing up but hating it.<\/p>\n

Good therapy<\/a> involves difficult, anxiety-provoking work, so most people will want to do that only if it is their only option for reaching specific goals. That is why it can be important for your referral proposal to include a reference to those goals, and to the way their emotional difficulties hold them back. An example could be: \u00e2\u20ac\u0153Seems like the headaches you are getting are really hassling you at work, and it seems like they get worse with stress. Therapy can help with that and it might make you less miserable at work and home.\u00e2\u20ac\u009d In this example, it is clear the referral is in the service of the person\u00e2\u20ac\u2122s feelings and interests, done out of care and concern for them and not out of some demand or expectation by the referral source.<\/p>\n

2. Make it optional.<\/strong><\/h3>\n

I encourage you to make your recommendation optional, with liberal use of comments such as, \u00e2\u20ac\u0153It\u00e2\u20ac\u2122s really up to you,\u00e2\u20ac\u009d \u00e2\u20ac\u0153I\u00e2\u20ac\u2122m not sure if I\u00e2\u20ac\u2122m right, but it\u00e2\u20ac\u2122s something you can decide for yourself,\u00e2\u20ac\u009d and, \u00e2\u20ac\u0153It\u00e2\u20ac\u2122s not a requirement, just a thought.\u00e2\u20ac\u009d I encourage you to phrase your referral as optional because going to therapy is <\/em>optional. Therapy is anxiety-provoking enough to begin with, and we only add anxiety if we make the person feel like it\u00e2\u20ac\u2122s an expectation, a demand, or a requirement.<\/p>\n

When we approach therapy as a demand or requirement instead of an option, we can trigger a few responses that decrease the effectiveness of our referral. If the person we are hoping to refer has submissive tendencies, they may comply with our <\/em>wish that they be in therapy. That will get them as far as a therapist\u00e2\u20ac\u2122s office, but because they are not there of their own free will, they may not get the full benefits of the therapy. Other people may respond to our demand that they seek therapy with defiance or stubbornness. Rather than consider the option, they may say no just to spite you and to stymie your efforts to control them, even if they feel therapy could help.<\/p>\n

Therapy has the highest likelihood of helping if the person is there of their own volition, not out of compliance, so be sure to remind yourself and the person you want to refer that the referral is optional.<\/p>\n

If we\u00e2\u20ac\u2122re clear about the reality of therapy\u00e2\u20ac\u201dthat the length of treatment and the level of commitment is up to them\u00e2\u20ac\u201dthey may find it less threatening and be more likely to try it.<\/span><\/p>\n

3. Make it conditional.<\/strong><\/h3>\n

What do we commit to when we commit to meeting with a therapist? Many people fear that by meeting with a therapist, they are committing to a long-term relationship. They sometimes also fear the therapist will decide how long the therapy lasts. These are anxiety-provoking preconceptions, and they are incorrect. When we try to refer people to therapy, it is important that we remind them of the truth\u00e2\u20ac\u201dthey are agreeing to one session at a time, and the length of the treatment is their choice, based on their goals and preferences.<\/p>\n

It may help to be frank about what an initial therapy session is: a test drive. You can say, \u00e2\u20ac\u0153You can meet with Maury and decide if you\u00e2\u20ac\u2122d like to meet with him again. The first session or sessions can help you decide if you think he might help. You may know right away you\u00e2\u20ac\u2122d like to meet with him more, but sometimes it can take a few sessions to decide if it\u00e2\u20ac\u2122s worth continuing to invest in the therapy. Either way, it\u00e2\u20ac\u2122s up to you how many sessions you go for. A therapist is an employee whom you can hire and fire.\u00e2\u20ac\u009d<\/p>\n

When we present the idea of therapy as a test drive, something the person can continue for as long as it meets certain conditions for them, we take away anxieties that therapy will be more of a commitment than the person may want. If we\u00e2\u20ac\u2122re clear about the reality of therapy\u00e2\u20ac\u201dthat the length of treatment and the level of commitment is up to them\u00e2\u20ac\u201dthey may find it less threatening and be more likely to try it.<\/p>\n

4. Do not make promises.<\/strong><\/h3>\n

Ethically speaking, even a therapist cannot make promises, predictions, or guarantees about what they can do. We do not have a crystal ball with which to see the future. Often, my initial phone call with a new referral includes a difficult conversation along these lines:<\/p>\n

Person: \u00e2\u20ac\u0153So, do you think you can help me?\u00e2\u20ac\u009d<\/p>\n

Me: \u00e2\u20ac\u0153Well, for better or worse I can\u00e2\u20ac\u2122t know that just yet. We\u00e2\u20ac\u2122d have to meet for you to form an opinion about that.\u00e2\u20ac\u009d<\/p>\n

Even if it\u00e2\u20ac\u2122s a bit disillusioning, this is the truth. Like physicians or personal trainers, therapists can\u00e2\u20ac\u2122t know whether their efforts will turn out to be helpful\u00e2\u20ac\u201donly time and a careful, continuous, collaborative assessment will tell. We find out if our treatment plan is helpful once it helps.<\/p>\n

There is great danger when a referral source makes promises about therapy or a therapist. Any expectations you give to the person you\u00e2\u20ac\u2122re trying to refer can give them false hope or make them unnecessarily anxious and avoidant.<\/span><\/p>\n

Every therapy session is, like every day of life, an experiment\u00e2\u20ac\u201dwe assess the problem that\u00e2\u20ac\u2122s going on, pick an intervention or style of intervention we think might help, try it out, see what result we get, and adjust our treatment plan according to what works and what doesn\u00e2\u20ac\u2122t. There is no magic to it, just a workaday process of trial and error, where we work hard to tailor a unique therapy to the unique person and their unique goals. In that sense, any preconceived expectations about therapy, just like in any other relationship, will be false.<\/p>\n

For these reasons, there is great danger when a referral source makes promises about therapy or a therapist. Any expectations you give to the person you\u00e2\u20ac\u2122re trying to refer can give them false hope or make them unnecessarily anxious and avoidant.<\/p>\n

For example, a referral source could say, \u00e2\u20ac\u0153He specializes in depression\u00e2\u20ac\u201dhe gets great outcomes.\u00e2\u20ac\u009d Even if that is true, no two depressions are the same because no two people are the same. Likewise, no two treatments are the same because no two therapy teams are the same. Making promises or suggestions regarding a particular outcome can promote misleading or false hope. It may also distract from the fact it\u00e2\u20ac\u2122s the work of the person in therapy<\/em>, not the work of the so-called \u00e2\u20ac\u0153expert in depression,\u00e2\u20ac\u009d that makes or breaks the therapy.<\/p>\n

Referral sources sometimes also make claims about a therapist\u00e2\u20ac\u2122s technique when making a referral. For example: \u00e2\u20ac\u0153He\u00e2\u20ac\u2122s a very confrontative therapist\u00e2\u20ac\u201dhe\u00e2\u20ac\u2122ll bust right through your defenses!\u00e2\u20ac\u009d While it may be true that a therapist is capable of being confrontative, and while that kind of therapy may be appropriate for some people\u00e2\u20ac\u2122s needs, presenting a referral in this way can be problematic. Good therapists base their technique on a careful assessment of the unique needs of the person in therapy, not based on what the therapist is good at or known for. Because of that, there is no guarantee the person you\u00e2\u20ac\u2122re referring will ever have their defenses \u00e2\u20ac\u0153confronted\u00e2\u20ac\u009d\u00e2\u20ac\u201dit all depends on the therapist\u00e2\u20ac\u2122s assessment of what might help in the moment. Making such claims about a therapist can set up false expectations or give a person something to fear. Imagine already being nervous about letting go of certain defense mechanisms and then hearing a therapist is going to \u00e2\u20ac\u0153bust right through\u00e2\u20ac\u009d them.<\/p>\n

For these reasons, when I refer someone to a therapist, I say something like, \u00e2\u20ac\u0153There\u00e2\u20ac\u2122s no way of knowing how it will go in advance, so the best way to find out whether the therapist can help is to go and check them out, assess how you feel with them, and make the best decision you can about whether to keep investing in the therapy. Hopefully they\u00e2\u20ac\u2122ll be flexible and you two can make a therapy together that meets your needs.\u00e2\u20ac\u009d<\/p>\n

5. Let go of your desires!<\/strong><\/h3>\n

If you haven\u00e2\u20ac\u2122t caught it yet, my main thesis here is that while we can suggest that someone goes to therapy, or reveal our desire that they go, it is up to them. Pressuring people into doing something that is anxiety-provoking will usually lead to avoidance, submissive compliance, or stubborn defiance.<\/p>\n

It is hard, but we must accept that we all have the right to avoid therapy and the anxieties that are built into it. No matter how badly we want to see a friend, loved one, or other person get help, our<\/em> wanting it cannot make them<\/em> want it. Only their inner desires can do that. So, while we can feel free to make suggestions to people about going to therapy, we must remember that they can do it only for them, not for us. Our desires for them can play only a very limited role in someone else\u00e2\u20ac\u2122s therapy journey.<\/p>\n

Example of Referring Someone to Therapy<\/h2>\n

Here is an example, based on the principles above, of what I might say to refer someone to a therapist:<\/p>\n

\u00e2\u20ac\u0153You seem to be suffering a lot and you\u00e2\u20ac\u2122ve been clear that you\u00e2\u20ac\u2122re not liking that, so I\u00e2\u20ac\u2122ve been thinking that therapy might be useful to you. Obviously, it\u00e2\u20ac\u2122s up to you if you want to go, but I do have the name of a person who I think might be able to help. Of course, that\u00e2\u20ac\u2122s no guarantee, and you may have to shop around a bit to find someone who is a good fit. Either way, if you want to check this person out, they could be helpful. Do you want me to pass their contact info along?\u00e2\u20ac\u009d<\/p>\n

You can phrase this any way you like, but I think the key points for any referral are here:<\/p>\n

    \n
  1. Seems like you\u00e2\u20ac\u2122re hurting, so therapy might be worth a shot.<\/li>\n
  2. It\u00e2\u20ac\u2122s up to you.<\/li>\n
  3. You\u00e2\u20ac\u2122re not committing to a lifetime on the couch, just one initial session.<\/li>\n
  4. There\u00e2\u20ac\u2122s no guarantee it\u00e2\u20ac\u2122ll be worthwhile, but the only way to find out is by trying.<\/li>\n<\/ol>\n

    Of course, this approach does not guarantee a specific outcome, but I believe it gives the best possible chance that the person will feel cared about by you, make the decision for themselves, and have the most realistic expectations possible going into therapy. Let me know if this helps!<\/p>\n","protected":false},"excerpt":{"rendered":"

    The idea of going to therapy can be anxiety-provoking enough. Here\u00e2\u20ac\u2122s how to make a referral to a therapist without triggering unnecessary fear or avoidance.<\/p>\n","protected":false},"author":2977,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[542,626,628],"tags":[579,1345,99,213,73],"class_list":["post-38703","post","type-post","status-publish","format-standard","hentry","category-featured-articles","category-for-therapists-by-therapist","category-general","tag-for-therapists","tag-going-to-therapy","tag-psychotherapy","tag-referrals","tag-therapy"],"acf":{"author_show":false,"author_name":"","author_role":"","author_avatar":null,"author_profile_url":""},"_links":{"self":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts\/38703","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/users\/2977"}],"replies":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/comments?post=38703"}],"version-history":[{"count":0,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts\/38703\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/media?parent=38703"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/categories?post=38703"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/tags?post=38703"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}